Medical dressing interface devices, systems, and methods

ABSTRACT

An adapter for providing fluid communication with a tissue site may include a base, a conduit housing, a primary port, at least one ancillary port, and at least one port extension. The base may define a mounting plane having a first planar side and a second planar side opposite the first planar side. The conduit housing may be supported by the base and may include a recessed region defining an entry surface. The conduit housing and the recessed region may be positioned on the first planar side with the entry surface facing the first planar side. The primary port may be on the entry surface, and the at least one ancillary port may be on the entry surface. A distal end of the port extension may be positioned on the second planar side in fluid communication with the ancillary port. Other devices, systems, and methods are disclosed.

RELATED APPLICATIONS

This application is a divisional of U.S. patent application Ser. No.15/198,891, filed Jun. 30, 2016, which claims the benefit, under 35 USC119(e), of the filing of U.S. Provisional Patent Application No.62/192,425, entitled “Medical Dressing Interface Devices, Systems, andMethods,” filed Jul. 14, 2015, which is incorporated herein by referencefor all purposes.

TECHNICAL FIELD

This disclosure relates generally to tissue treatment systems, and moreparticularly, but without limitation, to medical dressing interfacedevices, systems, and methods that may be suitable for use withreduced-pressure therapy and instillation therapy.

BACKGROUND

Clinical studies and practice have shown that reducing pressure inproximity to a tissue site can augment and accelerate growth of newtissue at the tissue site. The applications of this phenomenon arenumerous, but have been proven particularly advantageous for treatingwounds. Regardless of the etiology of a wound, whether trauma, surgery,or another cause, proper care of the wound is important to the outcome.Treatment of wounds or other tissue with reduced pressure may becommonly referred to as “reduced-pressure therapy.” However, suchtreatment may also be known by other names including “negative-pressuretherapy,” “negative-pressure wound therapy,” “vacuum therapy,”“vacuum-assisted closure,” and “topical negative-pressure,” for example.Reduced-pressure therapy may provide a number of benefits, includingmigration of epithelial and subcutaneous tissues, improved blood flow,and micro-deformation of tissue at a tissue site. Together, thesebenefits can increase development of granulation tissue and reducehealing times.

Cleansing a tissue site can also be highly beneficial for new tissuegrowth. For example, a tissue site can be washed with a stream of liquidsolution, or a cavity can be washed using a liquid solution fortherapeutic purposes. Further, fluid may be introduced to a tissue siteand left at the tissue site for a prescribed period of time beforeremoving the fluid. These practices may be referred to as “irrigation,”“lavage,” and “instillation.” Instillation of topical treatmentsolutions over a wound bed or other tissue site can be combined withreduced-pressure therapy to further promote healing and tissue growth byloosening soluble contaminants and removing infectious material. As aresult, soluble bacterial burden can be decreased, contaminants removed,and the tissue site cleansed.

Cost and complexity can limit the application of reduced-pressuretherapy and instillation therapy systems. Development and operation oftherapy systems, components, and processes may benefit manufacturers,healthcare providers, and patients.

SUMMARY

New and useful devices, systems, and methods that may be suitable foruse with reduced-pressure therapy and instillation therapy are set forthin the appended claims. For example, in some illustrative embodiments,an adapter for providing fluid communication with a distributionmanifold at a tissue site may include a base, a conduit housing, aprimary port, at least one ancillary port, and at least one portextension. The base may define a mounting plane having a first planarside and a second planar side opposite the first planar side. Further,the base may include a mounting surface coplanar with the first planarside and facing the first planar side. The conduit housing may besupported by the base and may include a recessed region defining anentry surface. The conduit housing and the recessed region may bepositioned on the first planar side with the entry surface facing thefirst planar side. The primary port may be on the entry surface, and theat least one ancillary port may be on the entry surface. The at leastone port extension may include a proximal end, a distal end, and a borebetween the proximal end and the distal end. The distal end of the portextension may be positioned on the second planar side in fluidcommunication with the ancillary port through the bore.

In some illustrative embodiments, a system for treating a tissue sitemay include a distribution manifold, an adapter, and a reduced pressuresource. The distribution manifold may include a tissue-facing sideadapted to face the tissue site, and an outward-facing side opposite thetissue-facing side. The adapter may be for providing fluid communicationwith the distribution manifold. The adapter may include a base, aconduit housing, a primary port, at least one ancillary port, and atleast one port extension. The base may include a mounting surfaceadapted to be positioned on the distribution manifold. The conduithousing may be supported by the base and may include a recessed regiondefining an entry surface. The entry surface may be adapted to bepositioned facing the distribution manifold. The primary port may bepositioned on the entry surface, and the at least one ancillary port maybe positioned on the entry surface. The at least one port extension mayinclude a proximal end, a distal end, and a bore between the proximalend and the distal end. The distal end of the port extension may beadapted to extend into the distribution manifold when the mountingsurface is positioned on the distribution manifold. The distal end ofthe port extension may also be in fluid communication with the ancillaryport through the bore. The reduced pressure source may be adapted to bepositioned in fluid communication with the primary port through theconduit housing

In some illustrative embodiments, a method for evaluating a service lifeof a distribution manifold for treating a tissue site may includepositioning the distribution manifold on a surface of the tissue site.The distribution manifold may include a tissue-facing side facing thetissue site, and an outward-facing side opposite the tissue-facing side.Further, the method may include positioning an adapter on thedistribution manifold. The adapter may include a conduit housing, aprimary port, a first ancillary port, a second ancillary port, and aport extension. The conduit housing may include a recessed regiondefining an entry surface. The entry surface may face the outward-facingside of the distribution manifold. The primary port may be on the entrysurface. Further, the first ancillary port and the second ancillary portmay be on the entry surface. The port extension may include a proximalend, a distal end, and a bore between the proximal end and the distalend. The distal end of the port extension may be in fluid communicationwith the first ancillary port. Further, the method may include insertingthe distal end of the port extension into the distribution manifold, andapplying reduced pressure to the distribution manifold through theprimary port. Further, the method may include measuring a first pressurebetween the surface of the tissue site and the tissue-facing side of thedistribution manifold through the first ancillary port and the distalend of the port extension. Further, the method may include measuring asecond pressure at the outward-facing side of the distribution manifoldthrough the second ancillary port. Further, the method may includecalculating a difference between the first pressure and the secondpressure to provide a differential pressure.

In some illustrative embodiments, a method for treating a tissue sitemay include providing a distribution manifold. The distribution manifoldmay include a tissue-facing side for facing the tissue site, and anoutward-facing side opposite the tissue-facing side. Further, the methodmay include applying reduced pressure to the outward-facing side of thedistribution manifold. Further, the method may include measuring a firstpressure at the tissue-facing side of the distribution manifold.Further, the method may include measuring a second pressure at theoutward-facing side of the distribution manifold. Further, the methodmay include calculating a difference between the first pressure and thesecond pressure to provide a differential pressure.

In some illustrative embodiments, a method for measuring and controllingpressure at a tissue site may include positioning a distributionmanifold adjacent a surface of the tissue site. The distributionmanifold may include a tissue-facing side facing the tissue site, and anoutward-facing side opposite the tissue-facing side. Further, the methodmay include positioning an adapter adjacent the distribution manifold.The adapter may include a conduit housing, a primary port, a firstancillary port, a second ancillary port, a first port extension, and asecond port extension. The conduit housing may include a recessed regiondefining an entry surface. The entry surface may face the outward-facingside of the distribution manifold. The primary port may be on the entrysurface. Further, the first ancillary port and the second ancillary portmay be on the entry surface. The first port extension and the secondport extension may each include a proximal end, a distal end, and a borebetween the proximal end and the distal end. The distal end of the firstport extension may be in fluid communication with the first ancillaryport, and the distal end of the second port extension may be in fluidcommunication with the second ancillary port. Further, the method mayinclude inserting the distal end of the first port extension and thedistal end of the second port extension into the distribution manifold.Further, the method may include applying reduced pressure from a reducedpressure source to the distribution manifold through the primary port.Further, the method may include measuring a first pressure between thetissue-facing side of the distribution manifold and the surface of thetissue site through the first port extension. Further, the method mayinclude measuring a second pressure between the tissue-facing side ofthe distribution manifold and the surface of the tissue site through thesecond port extension. Further, the method may include controlling thereduced pressure from the reduced pressure source according to the firstpressure and the second pressure.

In some illustrative embodiments, a method for measuring and controllingpressure at a tissue site may include positioning a distributionmanifold adjacent a surface of the tissue site. The distributionmanifold may include a tissue-facing side facing the tissue site, and anoutward-facing side opposite the tissue-facing side. Further, the methodmay include applying reduced pressure from a reduced pressure source tothe distribution manifold. Further, the method may include measuring afirst pressure between the surface of the tissue site and thetissue-facing side of the distribution manifold. Further, the method mayinclude measuring a second pressure between the surface of the tissuesite and the tissue-facing side of the distribution manifold. Further,the method may include controlling the reduced pressure from the reducedpressure source according to the first pressure and the second pressure.

In some illustrative embodiments, a method for instilling fluid at atissue site may include positioning a distribution manifold adjacent asurface of the tissue site. The distribution manifold may include atissue-facing side facing the tissue site, and an outward-facing sideopposite the tissue-facing side. Further, the method may includepositioning an adapter adjacent the distribution manifold. The adaptermay include a conduit housing, a primary port, at least one ancillaryport, and at least one port extension. The conduit housing may include arecessed region defining an entry surface. The entry surface may facethe outward-facing side of the distribution manifold. The primary portmay be on the entry surface, and the at least one ancillary port may beon the entry surface. The at least one port extension may include aproximal end, a distal end, and a bore between the proximal end and thedistal end. The distal end of the port extension may be in fluidcommunication with the ancillary port through the bore. Further, themethod may include inserting the distal end of the port extension intothe distribution manifold, and delivering fluid to the surface of thetissue site through the ancillary port and the distal end of the portextension.

In some illustrative embodiments, a method for instilling fluid at atissue site may include positioning a distribution manifold adjacent asurface of the tissue site. The distribution manifold may include atissue-facing side facing the tissue site, and an outward-facing sideopposite the tissue-facing side. Further, the method may includedelivering fluid directly between the surface of the tissue site and thetissue-facing side of the distribution manifold.

In some illustrative embodiments, an adapter for providing fluidcommunication with a distribution manifold at a tissue site may includea base, a housing, a primary port, at least one ancillary port, and atleast one fluid pathway. The base may include a mounting surface. Thehousing may be supported by the base. The housing may include an openingextending inbound of the mounting surface of the base. The primary portand the at least one ancillary port may be positioned in the opening.The at least one ancillary fluid pathway may extend from the at leastone ancillary port outbound of the mounting surface of the base.

In some embodiments, the at least one ancillary fluid pathway may extendbeyond the mounting surface of the base. Further, in some embodiments,the primary port and the at least one ancillary port may be positionedinbound of the mounting surface of the base and on an interior surfaceof the opening. Further, in some embodiments, the primary port may bespaced apart from the at least one ancillary port such that the at leastone ancillary port is positioned closer to the mounting surface of thebase than the primary port. Further, in some embodiments, the at leastone ancillary fluid pathway may have a proximal end and a distal end.The proximal end of the at least one ancillary fluid pathway may bepositioned inbound of the mounting surface of the base. The distal endof the at least one ancillary fluid pathway may be positioned outboundof the mounting surface of the base. Further, in some embodiments, theopening of the housing may have an apex positioned inbound of themounting surface of the base, and the primary port may be positioned atthe apex. In some embodiments, the at least one ancillary fluid pathwaymay include an auxiliary tube. The auxiliary tube may include a proximalend, a distal end, and a bore between the proximal end and the distalend. The distal end of the auxiliary tube may be positioned outbound pfthe mounting surface of the base and in fluid communication with theancillary port through the bore.

In some illustrative embodiments, a method for treating a tissue sitemay include positioning a distribution manifold on a surface of thetissue site. The distribution manifold may include a tissue-facing sidefacing the tissue site and an outward-facing side opposite thetissue-facing side. Further, the method may include providing anadapter. The adapter may include a conduit housing, a primary port, anancillary port, and an ancillary fluid pathway. The conduit housing mayinclude a recessed region defining an entry surface. The primary portand the ancillary port may be positioned on the entry surface. Theancillary fluid pathway may be disposed through the conduit housing andextend outward from the conduit housing. Further, the method may includepositioning the adapter on the distribution manifold such that theancillary port is positioned on the outward-facing side of thedistribution manifold and the ancillary fluid pathway extends into thedistribution manifold.

In some embodiments, the entry surface may face the outward-facing sideof the distribution manifold when the adapter is positioned on thedistribution manifold. Further, in some embodiments, the method mayinclude applying reduced pressure to the distribution manifold throughthe primary port; measuring a first pressure through the ancillary fluidpathway; measuring a second pressure through the ancillary port; andcalculating a difference between the first pressure and the secondpressure to provide a differential pressure. In some embodiments, thefirst pressure may be measured between the surface of the tissue siteand the tissue-facing side of the distribution manifold. Further, insome embodiments, the second pressure may be measured at theoutward-facing side of the distribution manifold. Further, in someembodiment, the method may include changing the distribution manifold ifthe differential pressure is greater than 15 mm Hg.

Objectives, advantages, and a preferred mode of making and using theclaimed subject matter may be understood best by reference to theaccompanying drawings in conjunction with the following detaileddescription of illustrative embodiments.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a partially schematic, perspective view of a reduced pressurewound treatment (RPWT) system including improvements according to anexample embodiment of this disclosure;

FIG. 2 is a perspective view of an underside or open side of an improvedadapter according to an example embodiment of this disclosure;

FIG. 3 is a plan view of a topside or closed side of the improvedadapter of FIG. 2;

FIG. 4 is a first side view of the improved adapter of FIG. 2;

FIG. 5 is an end view of the improved adapter of FIG. 2;

FIG. 6 is a second side view of the improved adapter of FIG. 2;

FIG. 7 is a plan view of an underside or open side of the improvedadapter of FIG. 2, the underside configured according to an exampleembodiment of this disclosure;

FIG. 8 is a plan view of an underside or open side of the improvedadapter of FIG. 2, the underside configured according to another exampleembodiment of this disclosure;

FIG. 9 is a detailed view of an example embodiment of a recessed regionof the adapter of FIGS. 7 and 8;

FIG. 10 is a perspective view of an underside or open side of animproved adapter illustrating at least one port extension according toan example embodiment of this disclosure;

FIG. 11 is a perspective view of an underside or open side of animproved adapter illustrating at least one port extension according toanother example embodiment of this disclosure;

FIG. 12A is a perspective view of an example embodiment of adistribution manifold suitable for use with a RPWT system according tothis disclosure;

FIG. 12B is a perspective view of another example embodiment of adistribution manifold suitable for use with a RPWT system according tothis disclosure;

FIG. 13A is a perspective view of an open end of an improved deliverytube according to an example embodiment of this disclosure;

FIG. 13B is a longitudinal cross-sectional view of the improved deliverytube of FIG. 13A;

FIG. 14A is a perspective view of an open end of an improved deliverytube according to another example embodiment of this disclosure;

FIG. 14B is a longitudinal cross-sectional view of the improved deliverytube of FIG. 14A;

FIG. 15 is a schematic block diagram illustrating a reduced pressuresystem according to an example embodiment of this disclosure;

FIG. 16 is a partially schematic, perspective view of a reduced pressurewound treatment (RPWT) system including improvements according toanother example embodiment of this disclosure;

FIG. 17 is a cut-away view of a split connector coupled to a portion ofa delivery tube according to an example embodiment of this disclosure;

FIG. 18 is a schematic block diagram illustrating a reduced pressuresystem according to another example embodiment of this disclosure;

FIG. 19 is a graphical plot of pressure measured at a tissue site by anadapter according to this disclosure compared to a plot of actualpressure present at the tissue site; and

FIG. 20 is a graphical plot of pressure measured at an outward-facingside of a distribution manifold compared to a plot of pressure measuredat a tissue-facing side of a distribution manifold according to thisdisclosure.

DETAILED DESCRIPTION OF EXAMPLE EMBODIMENTS

The following detailed description of example embodiments makesreference to the accompanying drawings and provides sufficientinformation to enable a person skilled in the art to make and use thesubject matter set forth in the appended claims. However, the detaileddescription may omit details known in the art. Other embodiments may bepossible, and structural, mechanical, electrical, and chemicalmodifications may be made to the example embodiments herein withoutdeparting from the scope of this disclosure as defined by the appendedclaims. Therefore, the following detailed description is illustrativeand non-limiting.

Provided are improvements to reduced-pressure therapy and instillationtherapy systems that may include an adapter to improve operationalreliability. For example, the adapter may be configured to prevent orreduce instances of unintentional liquid ingress into measurement lumensor sensing lumens associated with a therapy system. Further, the adaptermay be configured to position measurement lumens, sensing lumens, orinstillation lumens, which may all be referred to as ancillary lumens,closer to a point of interest at a tissue site, such as a surface of thetissue site. The lumens may be separate or isolated from communicatingwith one another between the point of interest and components, such as,without limitation, a sensor, an instillation reservoir, or a reducedpressure source. Such a configuration may increase the accuracy ofpressure measurements at the tissue site, and provide for efficient useof instillation fluid. Improvements to reduced-pressure therapy andinstillation therapy methodologies are also provided.

Herein, the term “tissue site” may broadly refer to a wound, defect, orother treatment target located on or within tissue, including but notlimited to, bone tissue, adipose tissue, muscle tissue, neural tissue,dermal tissue, vascular tissue, connective tissue, cartilage, tendons,or ligaments. A wound may include chronic, acute, traumatic, subacute,and dehisced wounds, partial-thickness burns, ulcers (such as diabetic,pressure, or venous insufficiency ulcers), flaps, and grafts, forexample. The term “tissue site” may also refer to areas of any tissuethat are not necessarily wounded or defective, but are instead areas inwhich it may be desirable to add or promote the growth of additionaltissue. For example, negative pressure may be applied to a tissue siteto grow additional tissue that may be harvested and transplanted.

Although reference may be made to a wound, the devices, systems, andmethodologies herein are provided without limitation to any particulartype of tissue site.

Further, the term “negative pressure” may refer to a pressure less thana local ambient pressure, such as the ambient pressure external to asealed therapeutic environment that may be provided by a therapy system,or portion of a therapy system, such as a dressing. The local ambientpressure may also be the atmospheric pressure at the location of atissue site. The pressure may also be less than a hydrostatic pressureassociated with tissue at the tissue site. Unless otherwise indicated,values of pressure stated herein are gauge pressures. Further,references to increases in negative pressure may refer to a decrease inabsolute pressure, while decreases in negative pressure may refer to anincrease in absolute pressure. While the amount and nature of negativepressure applied to a tissue site may vary according to therapeuticrequirements, the pressure is generally a low vacuum, also commonlyreferred to as a rough vacuum, that may be between −5 mm Hg (−667 Pa)and −500 mm Hg (−66.7 kPa). Common therapeutic ranges may be between −75mm Hg (−9.9 kPa) and −300 mm Hg (−39.9 kPa).

Reference is made first to FIG. 1 for a general description ofcomponents that may be included in a reduced pressure wound treatment(RPWT) system according to an example embodiment of this disclosure. Insome embodiments, a RPWT system 10 may include a wound dressing 12, adelivery tube 14, and a fluid containment and instrumentation assembly16. The fluid containment and instrumentation assembly 16 may include afluid container 18 and instrumentation components 20. Further, the RPWTsystem 10 may include an adapter 22 that may be in fluid communicationbetween the wound dressing 12 and the delivery tube 14. The deliverytube 14 may be in fluid communication between the adapter 22 and thefluid containment and instrumentation assembly 16. In some embodiments,the adapter 22 may be included as part of the wound dressing 12. TheRPWT system 10 is shown in FIG. 1 in one embodiment as a RPWT system 10a. FIG. 16 discloses another embodiment of the RPWT system 10, referredto as a RPWT system 10 b. References herein to the RPWT system 10 mayrefer to elements or components that may be associated with both theRPWT system 10 a and the RPWT system 10 b. Further, like referencenumerals herein and among the drawing figures may refer to like elementsand components.

The wound dressing 12 may include a distribution manifold 24, such as aporous pad or granular foam, and a cover or drape 26 that may secure thedistribution manifold 24 at a tissue site 25. The adapter 22 may providefluid communication with the distribution manifold 24, and may bepositioned on the distribution manifold 24 and adhered thereto by, forexample, an adhesive positioned on the adapter 22, the wound drape 26,or a separate adhesive drape associated with the adapter 22.

The fluid container 18 may be representative of a container, canister,pouch, or other storage component suitable for managing exudates andother fluids withdrawn from the tissue site 25. In some embodiments, thefluid container 18 may be a rigid container suitable for collecting,storing, and disposing of fluids.

The distribution manifold 24 may include any substance or structureproviding a plurality of pathways adapted to collect or distribute fluidacross a tissue site, such as the tissue site 25, under pressure. Forexample, the distribution manifold 24 may be adapted to receive negativepressure from a source and to distribute negative pressure throughmultiple apertures across the tissue site 25, which may have the effectof collecting fluid from across the tissue site 25 and drawing the fluidtoward the source. In some embodiments, the fluid path may be reversedor a secondary fluid path may be provided to facilitate delivering fluidacross the tissue site 25.

In some embodiments, the pathways of the distribution manifold 24 may beinterconnected to improve distribution or collection of fluids acrossthe tissue site 25. Further, in some embodiments, the distributionmanifold 24 may be a porous foam material having interconnected cells orpores. For example, cellular foam, open-cell foam, reticulated foam,porous tissue collections, and other porous material such as gauze orfelted mat generally include pores, edges, or walls adapted to forminterconnected fluid channels. Liquids, gels, and other foams may alsoinclude or be cured to include apertures and fluid pathways. In someembodiments, the distribution manifold 24 may additionally oralternatively comprise projections that form interconnected fluidpathways. For example, the distribution manifold 24 may be molded toprovide surface projections that define interconnected fluid pathways.

In one non-limiting example, the distribution manifold 24 may be anopen-cell, reticulated polyurethane foam such as GranuFoam® dressing orVeraFlo® foam, both available from Kinetic Concepts, Inc. of SanAntonio, Tex. Further, in some embodiments, the distribution manifold 24may be either hydrophobic or hydrophilic. In an example in which thedistribution manifold 24 may be hydrophilic, the distribution manifold24 may also wick fluid away from the tissue site 25, while continuing todistribute negative pressure to the tissue site 25. The wickingproperties of the distribution manifold 24 may draw fluid away from thetissue site 25 by capillary flow or other wicking mechanisms. An exampleof a hydrophilic foam is a polyvinyl alcohol, open-cell foam such asV.A.C. WhiteFoam® dressing available from Kinetic Concepts, Inc. of SanAntonio, Tex. Other hydrophilic foams may include those made frompolyether. Other foams that may exhibit hydrophilic characteristicsinclude hydrophobic foams that have been treated or coated to providehydrophilicity.

The drape 26 may be, for example, an elastomeric film or membrane thatcan provide a seal adequate to maintain a negative pressure at thetissue site 25 for a given negative-pressure source. The drape 26 mayhave a high moisture-vapor transmission rate (MVTR) in some embodiments.For example, the MVTR may be at least 300 g/m̂2 per twenty-four hours insome embodiments. In some example embodiments, the drape 26 may be apolymer drape, such as a polyurethane film, that may be permeable towater vapor but impermeable to liquid. In such an embodiment, the drape26 may have a thickness in the range of 25-50 microns. For permeablematerials, the permeability generally should be low enough that adesired negative pressure may be maintained.

The delivery tube 14 may include one or more tubing sections 28 which,as an assembled structure, may provide a continuous conduit between theadapter 22 and a container connector 34 that may be positioned on thefluid container 18. Liquid and exudates drawn by the RPWT system 10 maybe removed from the delivery tube 14 at the container connector 34 andbe retained within the fluid container 18. Sections of additional tubingin the form of instrumentation tubing 36 may extend from the containerconnector 34 to the instrumentation components 20.

As shown in FIG. 1, in some embodiments, the instrumentation components20 may include a reduced pressure source 38, a pressure sensor such as afirst pressure sensor 39, and another pressure sensor such as a secondpressure sensor 40. In other embodiments, as shown in FIG. 16 anddescribed further below, the instrumentation components 20 may includethe reduced pressure source 38, the pressure sensor 39, and aninstillation reservoir 41. Each of the instrumentation components 20 maybe individually associated with one isolated conduit, tube, or lumenthat may extend from the adapter 22 into the fluid containment andinstrumentation assembly 16.

As a non-limiting example, the reduced pressure source 38 may be areservoir of air at a negative pressure, or a manual orelectrically-powered device that can reduce the pressure in a sealedvolume, such as a vacuum pump, a suction pump, a wall suction portavailable at many healthcare facilities, or a micro-pump. The reducedpressure source 38 may be housed within or used in conjunction withother components, such as sensors, processing units, alarm indicators,memory, databases, software, display devices, or user interfaces thatmay further facilitate therapy. The reduced pressure source may alsohave one or more supply ports configured to facilitate coupling andde-coupling to one or more distribution components.

Reference is now made to FIGS. 2-9 for further description of thereduced pressure adapter 22. FIG. 2 illustrates structural elementswithin an opening of the adapter 22 that may be adapted to contact thedistribution manifold 24 of the wound dressing 12. The adapter 22 mayinclude a base 50 and a housing or a conduit housing 62 that may besupported by or coupled to the base 50.

The base 50 may be adhered to the distribution manifold 24 or to thedrape 26 shown in FIG. 1, for example. The base 50 may include a baseaperture 53 that may be positioned over the distribution manifold 24.Liquids and gases (collectively referred to as “fluid”) may be drawnfrom the tissue site 25 through the base aperture 53. The adapter 22 mayinclude channel elements positioned near and in fluid communication withthe base aperture 53. Described further below, the channel elements maydirect and route liquid for drainage while minimizing any interferencewith other components of the RPWT system 10, such as the instrumentationcomponents 20.

Further, the base 50 may include a mounting surface 33, and at least aportion of the mounting surface 33 may define a mounting plane 27. InFIGS. 2 and 4, the mounting plane 27 provides a reference or datum pointfor describing features of the adapter 22 in relation to one another.Thus, the mounting plane 27 is provided for illustration and does notform part of the adapter 22 or otherwise require any component of theadapter 22 to have a planar shape. The mounting plane 27 may have afirst proximal side or first planar side 29 and a second distal side orsecond planar side 31 opposite the first planar side 29. In someembodiments, the first planar side 29 and the second planar side 31 mayeach refer to a space or territory separated by the mounting plane 27.For example, a first space on the first planar side 29 may be positionedon an opposite side of the mounting plane 27 from a second space on thesecond planar side 31. The mounting surface 33 of the base 50 may becoplanar with the first planar side 29 and facing the first planar side29. The mounting surface 33 and the second planar side 31 may beconfigured to face or to be positioned on the distribution manifold 24.

Continuing with FIG. 2, the conduit housing 62 of the adapter 22 mayinclude an opening or a recessed region 54. The opening or recessedregion 54 may define an interior surface or an entry surface 55. Thebase 50 may be attached to the conduit housing 62 and positioned aboutthe recessed region 54. In some embodiments, the base 50 may partiallyor completely surround the recessed region 54. The conduit housing 62and the recessed region 54 may be positioned on the first planar side 29of the mounting plane 27 with the entry surface 55 facing the firstplanar side 29. Further, the entry surface 55 may be adapted to face thedistribution manifold 24. In some embodiments, the entry surface 55 maybe spaced apart from the first planar side 29 of the mounting plane 27.

In some embodiments, the opening or recessed region 54 of the conduithousing 62 may extend in an inbound direction relative to the mountingsurface 33 of the base 50. The inbound direction may generally be anopposite direction from a direction the mounting surface 33 isconfigured to face, such as a facing direction or outbound direction.The facing direction or outbound direction of the mounting surface 33may be configured to face the tissue site 25 or the distributionmanifold 24, for example.

A primary port 60 and at least one ancillary port, such as a firstancillary port 56 and a second ancillary port 58, may be positioned onthe entry surface 55. The primary port 60 may be centrally located orpositioned at an apex of the recessed region 54, and the ancillary ports56, 58 may be positioned near opposing edges of the base aperture 53.The apex of the recessed region 54 and the primary port 60 may be spacedapart from the first planar side 29 of the mounting plane 27. In someembodiments, the primary port 60 may be spaced apart from the ancillaryports 56, 58 such that the ancillary ports 56, 58 are positioned closerto the first planar side 29 of the mounting plane 27 than the primaryport 60.

In some embodiments, the conduit housing 62 may include a primaryconduit (not shown) and a pair of ancillary conduits (not shown) passingthrough or formed integrally within the conduit housing 62. A first endof the primary conduit may terminate on the entry surface 55 at theprimary port 60, and a first end of the ancillary conduits may terminateon the entry surface 55 at the ancillary ports 56, 58, respectively.

Further, in some embodiments, the conduit housing 62 may include aconduit housing aperture 66 that may be adapted to be coupled in fluidcommunication with the delivery tube 14. A primary lumen interface 64and at least one ancillary lumen interface, such as ancillary lumeninterfaces 48, 49, shown in FIG. 5, may be positioned within the conduithousing aperture 66. In some embodiments, the primary lumen interface 64may be centrally positioned within the conduit housing aperture 66, andthe ancillary lumen interfaces 48, 49 may be positioned about theprimary lumen interface 64. A second end of the primary conduit mayterminate at the primary lumen interface 64, and a second end of theancillary conduits may terminate at the ancillary lumen interfaces 48,49, respectively. Thus, the primary lumen interface 64 may be in fluidcommunication with the primary port 60 through the primary conduitwithin the conduit housing 62, and the ancillary lumen interfaces 48, 49may respectively be in fluid communication with the ancillary ports 56,58 through the ancillary conduits within the conduit housing 62.Accordingly, the reduced pressure source 38, shown in FIG. 1, may bepositioned in fluid communication with the primary port 60 through theconduit housing 62, such as, for example, through the primary lumeninterface 64. Similarly, in some embodiments, the first pressure sensor39 and the second pressure sensor 40, shown in FIG. 1, may be positionedin fluid communication with the ancillary ports 56, 58, respectively,through the conduit housing 62, such as, for example, through theancillary lumen interfaces 48, 49, respectively. In other embodiments,the pressure sensor 39 and the instillation reservoir 41, shown in FIG.16, may be positioned in fluid communication with the ancillary ports56, 58, respectively, through the conduit housing 62, such as, forexample, through the ancillary lumen interfaces 48, 49, respectively.Further embodiments are possible.

Referring to the topside, plan view of the adapter 22 shown in FIG. 3,the conduit housing 62 may be elbow shaped in some embodiments. However,in other embodiments, the conduit housing 62 may be configured at anydesired angle, or may extend perpendicularly from the base 50. Further,as shown in FIG. 3, in some embodiments, the conduit housing 62 mayinclude an elbow region 68, and may be centrally positioned relative tothe base 50.

Referring to FIG. 4, in some embodiments, the adapter 22 may have a lowprofile configuration with the base 50 defining the lateral limits ofthe adapter 22. As indicated above, the base 50 may be directly adheredto the distribution manifold 24, or may be positioned and adhered usingthe drape 26 of the wound dressing 12. The adapter 22 may be positionedon distribution manifold 24 such that the base aperture 53 (not seen inthis view) of the base 50 is in direct contact with the distributionmanifold 24. In the embodiment of FIG. 4, the primary lumen interface 64may extend outward from the conduit housing 62, and may be surrounded bythe conduit housing aperture 66. Conduits may extend through thesubstrate material of the adapter 22 between the interfaces 48, 49, 64and the recessed region 54, as described above. The elbow region 68 mayredirect fluid flow from the wound dressing 12, which may be positionedbeneath the adapter 22, to an angle associated with the primaryinterface 64 in a manner that may allow the RPWT system 10 to be placedon the wound dressing 12 and be maintained in a low profileconfiguration close to a surface of the wound dressing 12.

Referring to FIG. 5, another view of the adapter 22 and theconfiguration of the elbow region 68 and the internal configuration ofthe conduit housing 62 are shown. The base 50 and the conduit housingaperture 66 are positioned as described above in connection with FIG. 4.The conduit housing 62 may be positioned to receive a section of tubingfor connection to components of the RPWT system 10 as described herein.

Continuing with FIG. 5, also depicted are the primary lumen interface 64and the ancillary lumen interfaces 48 and 49. The ancillary lumeninterfaces 48 and 49 may align with corresponding lumens in the deliverytube 14 by, for example, placing a primary lumen 82 in the delivery tube14 over the primary lumen interface 64 as further described inconnection with FIGS. 13A-14B below.

Referring to FIG. 6, provided is a view of the adapter of FIG. 4 from anopposite side, illustrating the same components previously described inconnection with FIG. 4, and the symmetry of the adapter 22 as configuredin some embodiments. Unless otherwise indicated, the adaptor 22 may beconstructed of any materials capable of providing comfort to the patientwhile maintaining sufficient rigidity or resilience to maintain the openlumens, conduits, and passageways that are integral to the adapter 22.In some embodiments, the adapter 22 may be formed of flexible materials.

Referring to FIG. 7, depicted is another view of an embodiment of theadapter 22 to further illustrate the structure and function of elementswithin the recessed region 54 that may preference liquids and othernon-gaseous fluids away from the ancillary ports 56, 58. The base 50 maysubstantially or entirely surround an edge or perimeter of the recessedregion 54. The ancillary ports 56 and 58 are shown positioned asdescribed above. The primary port 60 can be seen centrally locatedwithin the recessed region 54. Structures within the recessed region 54that may serve to conduct liquid into the primary port 60 and theassociated primary conduit, and thereby allow the ancillary ports 56,58, and the associated ancillary conduits to remain unobstructed aredescribed in more detail below with respect to FIG. 9.

Referring to FIG. 8, depicted is another embodiment of the base 50,referred to as a base 52, that may be associated with the adapter 22.The base 52 may include base serrated guide channels 70, perimetercollection channels 72, and intermediate collection channels 74. In someembodiments, the base serrated guide channels 70, the perimetercollection channels 72, and the intermediate collection channels 74 maybe molded into a mounting surface 33 of the base 52. The base serratedguide channels 70, the perimeter collection channels 72, and theintermediate collection channels 74 as configured in FIG. 8 may directliquid away from the ancillary ports 56, 58 and into the primary port60. The base serrated guide channels 70 may be positioned and orientedon the base 52 to directly capture and channel a majority of the liquidsbeing drawn toward or into the adapter 22. The base serrated guidechannels 70 may be spaced and radially-oriented to funnel liquids awayfrom the ancillary ports 56, 58 and into the primary port 60. Inaddition, the perimeter collection channels 72 and the intermediatecollection channels 74 may redirect the flow of liquids among portionsof the base serrated guide channels 70 and away from the ancillary ports56, 58. An example of this redirected flow is shown in FIG. 8 withbolded flow indication arrows, where the radial channels 70 or the baseserrated guide channels 70 are positioned on the base 52 to directliquid from a periphery of the base 52 away from the ancillary ports 56,58. Further, the intermediate collection channels 74 may be positionedon the base 52 to direct liquid into the radial channels 70 or the baseserrated guide channels 70.

Reference is now made to FIG. 9 for further description of the featuresand elements that may be contained within the recessed region 54 of theconduit housing 62. These features may be positioned on the entrysurface 55 of the recessed region 54, and may be configured topreference liquids and other non-gaseous exudates away from theancillary ports 56, 58 and into the primary port 60. As shown, in someembodiments, the primary port 60 may be centrally positioned within therecessed region 54, and may extend from this central location to oneside of the recessed region 54. Further, the ancillary ports 56 and 58may be positioned to either side of the primary port 60. As shown, insome embodiments, the ancillary ports 56 and 58 may be circular openingsand may have raised circumferential edges.

Various elements shown in the embodiment of FIG. 9 may be positioned topreference liquid into the primary port 60 of the adapter 22. Forexample, the ancillary ports 56 and 58 may be positioned near aperimeter of the base aperture 53 (shown in FIG. 7) and the recessedregion 54, and at a level that may be close to a surface of thedistribution manifold 24 when the adapter 22 is positioned thereon.Accordingly, when the adapter 22 is positioned on the wound dressing 12,the ancillary ports 56 and 58 may be in contact, or nearly in contact,with the surface of the distribution manifold 24. Such a configurationmay minimize the likelihood of splashed or agitated liquid beingdirected into the ancillary ports 56 and 58.

Additional elements that may direct liquids into the primary port 60 arestructural serrated channels that may be formed on portions of the entrysurface 55 of the recessed region 54. A first linear serrated channelsection 42 may be positioned in association with an approximatelyhalf-circle section of the recessed region 54 that may be associatedwith the ancillary port 58. The material comprising this section of therecessed region 54 may form a ceiling covering and containing theconduit (not shown) that may extend within the conduit housing 62between the ancillary port 58 and one of the ancillary lumen interfaces48, 49 shown in FIG. 5. This ceiling may be configured with an array ofserrated channels or striations that may direct liquids that fall uponthis surface toward the primary port 60 within the recessed region 54.Any liquids that may fall upon this portion of the entry surface 55 maybe channeled directly into the primary port 60, rather than beingdirected into the ancillary port 58.

Continuing with FIG. 9, a similar configuration may be constructed in anapproximately one-third circular radial serrated channel section 44.Insofar as no internal conduit is contained within this section of therecessed region 54, the radial serrated channel section 44 may extenddeeper and more directly to the primary port 60. The radial serratedchannel section 44 may extend from a perimeter of the recessed region 54toward an apex of the recessed region 54 that drains into the primaryport 60. Further, the radial serrated channel section 44 may extend fromthe ancillary port 58 radially around approximately a one-third circularportion of the recessed region 54 to the ancillary port 56. Any liquidsthat fall upon the radial serrated channel section 44 of the recessedregion 54 may be directed to the primary port 60, rather than beingconducted to either of the ancillary ports 56, 58.

Further, a wall section that supports the ancillary port 56 at the pointat which the ancillary port 56 overhangs the primary port 60 may includeserrated or striated channels 46. For the orientation shown in FIG. 9,the serrated or striated channels 46 may extend downward from theopening of the ancillary port 56 toward the opening of the primary port60.

As described above, various elements of the recessed region 54 may beconfigured to draw liquid from within the recessed region 54 and todirect the liquid toward the primary port 60. Insofar as theconfiguration of the recessed region 54 provides little or no suction atthe ancillary ports 56, 58, the likelihood of obstructions in the formof liquid or material blocking the ancillary lumens 56, 58 may begreatly reduced.

Referring to FIGS. 10-11, in some embodiments, the adapter 22 mayinclude at least one auxiliary tube or port extension 37 that maydefine, form, or provide an ancillary fluid pathway that may extendbeyond or outbound of the mounting surface 33 of the base 50. Featuresdescribed in reference to the port extension 37 herein may be applicableto or interchangeable with the auxiliary tube and the ancillary fluidpathway. Each of the port extensions 37 may include a proximal end 43, adistal end 45, and a bore 47 between the proximal end 43 and the distalend 45. In some embodiments, a length of the port extension 37 betweenthe proximal end 43 and the distal end 45 may be between about 6millimeters to about 8 millimeters. The proximal end 43 of the portextension 37 may be positioned on or at the first planar side 29 of themounting plane 27, shown in FIG. 1, in fluid communication with one ormore of the ancillary ports 56, 58. In some embodiments, the proximalend 43 of the port extension 37 may be coupled to the entry surface 55about one or more of the ancillary ports 56, 58.

The distal end 45 of the port extension 37 of FIGS. 10-11 may extendthrough the mounting plane 27 to the second planar side 31 or beyond thesecond planar side 31. Thus, the port extension 37 may extend beyond themounting surface 33 through the mounting plane 27 to the second planarside 31 of the mounting plane 27. Further, the distal end 45 of the portextension 37 may be positioned on the second planar side 31, or beyondthe second planar side 31, and in fluid communication with one or moreof the ancillary ports 56, 58 through the bore 47. In some embodiments,the bore 47 of the port extension 37 may define an isolatedcommunication passageway between one or more of the ancillary ports 56,58 and the distal end 45 of the port extension 37. Further, the distalend 45 of the port extension 37 may be spaced apart from the mountingplane 27 on the second planar side 31.

In some embodiments, the port extension 37 may be collapsible oradjustable in a lengthwise direction. For example, in some embodiments,the port extension 37 may be formed of resilient or flexible materials,such as, without limitation a soft polymer or plasticized PVC material.Such materials may permit the port extension 37 to adjust or conform todifferent shapes and contours at the tissue site 25 while the bore 47 ofthe port extension 37 remains open or unobstructed. For example, thedistal end 45 of the port extension 37 may be moveable in a lengthwisedirection along an axis of the bore 47 closer to and farther away fromthe mounting plane 27 and the coplanar mounting surface 33. Further, insome embodiments, the port extension 37 may carry or be formed with abellows or corrugation (not shown) configured to permit a wall of theport extension 37 to collapse without restricting fluid communicationthrough the bore 47 of the port extension 37.

In some embodiments, the distal end 45 of the port extension 37 maycarry a plurality of castellations 57. In some embodiments, thecastellations 57 may be projections extending outward from the distalend 45 of the port extension 37. Further, in some embodiments, thecastellations 57 may be disposed about a perimeter of the distal end 45of the port extension 37. Further, in some embodiments, thecastellations 57 may be collapsible in an analogous manner as describedabove for the port extension 37. Further, in some embodiments, thecastellations 57 may be spaced apart from one another about the distalend 45 of the port extension 37. Further, in some embodiments, anopening 59 may be defined between each of the castellations 57. Theopening 59 may be in fluid communication with the bore 47 of the portextension 37, for example, to enhance pressure measurement orinstillation of fluids through the port extension 37 when the distal end45 of the port extension 37 is in contact with or in close proximity toa surface of the tissue site 25. Further, in some embodiments, thecastellations 57 may have a pitch or spacing of about 0.5 millimeters toabout 1.0 millimeters between one another. Such a pitch or spacing mayprovide a suitable amount of micro-force deformation at the tissue site25, which may promote healing and the formation of granulation tissue.

In some embodiments, the distal end 45 of the port extension 37 maycarry a plurality of apertures or holes (not shown) disposed through awall of the port extension 37. These apertures or holes may bepositioned near the distal end 45 and about a perimeter of the portextension 37. Further, the apertures or holes may be spaced apart fromone another about a perimeter or circumference of the port extension 37.Analogous to the opening 59 between the castellations 57, the aperturesor holes may be in fluid communication with the bore 47 of the portextension 37 to enhance pressure measurement or instillation of fluidsthrough the port extension 37 when the distal end 45 of the portextension 37 is in contact with or in close proximity to a surface ofthe tissue site 25.

Referring to FIG. 10, in some embodiments, the at least one portextension 37 may include a first port extension 37 a and a second portextension 37 b. The proximal end 43 of the first port extension 37 a maybe coupled about the first ancillary port 56, and the proximal end 43 ofthe second port extension 37 b may be coupled about the second ancillaryport 58. The first pressure sensor 39, shown in FIG. 1, may be in fluidcommunication with the first ancillary port 56 and the first portextension 37 a. In some embodiments, the second pressure sensor 40, alsoshown in FIG. 1, may be in fluid communication with the second ancillaryport 58 and the second port extension 37 b. In other embodiments, theinstillation reservoir 41, shown in FIG. 16, may be in fluidcommunication with the second ancillary port 58 and the second portextension 37 b. Other embodiments are possible.

Referring to FIG. 11, in some embodiments, the port extension 37 may bea single port extension 37 coupled to the entry surface 55 about thefirst ancillary port 56. For example, the proximal end 43 of the portextension 37 may be coupled to the entry surface 55 about the firstancillary port 56. Further, the distal end 45 of the port extension 37may extend outward from the entry surface 55 and beyond the mountingsurface 33 of the base 50 or the base 52. The second ancillary port 58may terminate at the entry surface 55. In some embodiments, the firstpressure sensor 39, shown in FIG. 1, may be positioned in fluidcommunication with the first ancillary port 56 and the port extension 37through the conduit housing 62. Further, the second pressure sensor 40,also shown in FIG. 1, may be positioned in fluid communication with thesecond ancillary port 58 at the entry surface 55 through the conduithousing 62.

Referring to FIGS. 12A-12B, the distribution manifold 24 may includeadditional elements for enhancing the RPWT system 10 and the usabilityof the adapter 22. For example, the distribution manifold 24 may includea tissue-facing side 61 adapted to face the tissue site 25, shown inFIG. 1, and an outward-facing side 63 opposite the tissue-facing side61. In some embodiments, the tissue-facing side 61 of the distributionmanifold 24 may be adapted to directly or substantially contact thetissue site 25. The drape 26, also shown in FIG. 1, may be adapted tocover the outward-facing side 63 of the distribution manifold 24 at thetissue site 25.

Continuing with FIGS. 12A-12B, with reference to FIGS. 8 and 10-11, themounting surface 33 of the base 50 or the base 52 may be adapted to bepositioned on the outward-facing side 63 of the distribution manifold24. The distal end 45 of the port extension 37 may be adapted to extendinto or to be pressed into the distribution manifold 24 when themounting surface 33 of the base 50 or the base 52 is positioned on thedistribution manifold 24. Further, a length of the port extension 37 maybe adapted to extend between the outward-facing side 63 and thetissue-facing side 61 of the distribution manifold 24. In someembodiments, the proximal end 43 of the port extension 37 may be adaptedto be positioned at the outward-facing side 63 of the distributionmanifold 24, and the distal end 45 of the port extension 37 may beadapted to be positioned at the tissue-facing side 61 of thedistribution manifold 24. Further, in some embodiments, the distal end45 of the port extension 37 may be adapted to contact the tissue site25.

Referring to FIG. 12A, in some embodiments, the distribution manifold 24may be a distribution manifold 24 a formed, for example, of a sheet orblock of any of the materials described above for the distributionmanifold 24, which may be cut or otherwise shaped to fit the tissue site25, shown in FIG. 1. Referring to FIG. 12B, in some embodiments, thedistribution manifold 24 may be a distribution manifold 24 b including aplurality of port apertures 65 sized, spaced, or otherwise adapted toreceive the least one port extension 37. In some embodiments, the portapertures 65 may have a diameter between about 2 millimeters to about 3millimeters, and a pitch or spacing between about 10 millimeters toabout 12 millimeters. The plurality of port apertures 65 may be disposedthrough a thickness of the distribution manifold 24 b, for example,between the outward-facing side 63 and the tissue-facing side 61. Insome embodiments, the thickness of the distribution manifold 24 a or 24b may be about 30 millimeters.

Reference is now made to FIGS. 13A-14B for further description of thedelivery tube 14. In some embodiments, the delivery tube 14 may includethe primary lumen 82 and at least one ancillary lumen, such as, forexample, a first ancillary lumen 84 and a second ancillary lumen 86.Further, in some embodiments, the delivery tube 14 may be a multi-lumentube 80, such as, for example, a multi-lumen tube 80 a, shown in FIGS.13A-13B, or a multi-lumen tube 80 b, shown in FIGS. 14A-14B. Themulti-lumen tubes 80 a, 80 b may also be used as one or more tubingsections 28 and the instrumentation tubing 36 shown and described inconnection with FIGS. 1 and 16. In other embodiments, the delivery tube14 may be comprised of single or individual lumens that may be routed orcoupled separate from one another to various components of the RPWTsystem 10 described herein.

The primary lumen 82 may be adapted to be in fluid communication betweenthe reduced pressure source 38 and the primary port 60 of the adapter 22through, for example, the primary conduit within the adapter 22,described above. Further, the at least one ancillary lumen 84, 86 may beadapted to be in fluid communication with one or more of the ancillaryports 56, 58 of the adapter 22 through, for example, the ancillaryconduits of the adapter 22, also described above. In some embodiments,the cross-sectional diameter of the primary lumen 82 may be larger orgreater than a cross-sectional diameter of the ancillary lumens 84 and86.

Referring to FIGS. 13A-13B, in some embodiments, the multi-lumen tube 80a may have an oval cross-section, which may enhance flexibility whileprecluding the collapse of any of the described lumens. Further, thisoval cross-sectional shape may also orient the ancillary lumens 84, 86in appropriate alignment with the ancillary lumen interfaces 48, 49 ofthe adapter 22 described above.

Referring to FIGS. 14A-14B, in some embodiments, the first ancillarylumen 84 may be a first pair of ancillary lumens 84 a, 84 b, and thesecond ancillary lumen 86 may be a second pair of ancillary lumens 86 a,86 b. The first pair of ancillary lumens 84 a, 84 b may be adapted to bein fluid communication with the first ancillary port 56, shown in FIG.2, and the second pair of ancillary lumens 86 a, 86 b may be adapted tobe in fluid communication with the second ancillary port 58, also shownin FIG. 2. As shown in FIGS. 14A-14B, the primary lumen 82, the firstpair of ancillary lumens 84 a, 84 b, and the second pair of ancillarylumens 86 a, 86 b may form part of the multi-lumen tube 80 b.

In some embodiments, the multi-lumen tube 80 b may also include analignment tab 85 configured or positioned on an exterior of themulti-lumen tube 80 b to orient the ancillary lumens 84, 86 inappropriate alignment with the ancillary lumen interfaces 48, 49 of theadapter 22 described above. In other embodiments, a colored line, dots,dashes, or emboss may be used alternatively or in addition to thealignment tab 85. For example, the first pair of ancillary lumens 84 a,84 b may be aligned with one of the ancillary lumen interfaces 48, 49,and the second pair of the ancillary lumens 86 a, 86 b may be alignedwith the other of the ancillary lumens interfaces 48, 49. The ancillarylumen interfaces 48, 49 are best viewed in FIG. 5, with reference toFIGS. 14A-14B. In the embodiment shown in FIG. 5, the ancillary lumeninterfaces 48, 49 may each include an arcuate passageway shaped to matewith one pair of the ancillary lumens shown in FIGS. 14A-14B, such asthe first pair of ancillary lumens 84 a, 84 b or the second pair ofancillary lumens 86 a, 86 b. Further, the arcuately shaped passageway ofthe ancillary lumen interfaces 48, 49, shown in FIG. 5, may also beconfigured to mate with the ancillary lumens 84, 86 in the multi-lumentube 80 a, shown in FIGS. 13A-13B, with an oval cross-section. Thus, theconfiguration of the ancillary lumen interfaces 48, 49 provides for theuse of both the cross-section of the multi-lumen tube 80 a, shown inFIG. 13B, and the cross-section of the multi-lumen tube 80 b, shown inFIG. 14B, in the RPWT system 10.

FIG. 15 is a schematic diagram illustrating additional details that maybe associated with some example embodiments of the RPWT system 10 a.FIG. 15 illustrates the reduced pressure source 38, the first pressuresensor 39, and the second pressure sensor 40 in separate fluidcommunication, for example, through separate lumens or conduits, withthe adapter 22 as previously described. The RPWT system 10 a mayadditionally include a controller 90, and solenoid valves 92, 94, and96. The controller 90 may be configured to receive pressure data fromthe first pressure sensor 39, the second pressure sensor 40, and thereduced pressure source 38. The controller 90 may also be programmed orconfigured to monitor pressure at the tissue site 25, shown in FIG. 1,through the pressure data received from the pressure sensors 39, 40. Thecontroller 90 may further be configured to operate the reduced pressuresource 38 for supplying reduced pressure to the adapter 22, such asthrough the previously described primary lumen 82 and primary port 60,according to the pressure data.

In some embodiments, the solenoid valve 92 may be in fluid communicationwith the first pressure sensor 39, the solenoid valve 94 may be in fluidcommunication with the second pressure sensor 40, and the solenoid valve96 may be in fluid communication with the reduced pressure source 38.The controller 90 may be electrically coupled or operable on thesolenoid valves 92, 94, and 96, and the reduced pressure source 38. Inthe RPWT system 10 a, the solenoid valves 92, 94, and 96 may becontrolled by the controller 90, for example, to regulate pressure atthe tissue site 25, and to clear blockages.

For example, in instances where liquid or other non-gaseous substanceenters one of the ancillary lumens 84, 86, a blockage may be created,causing a delay in a pressure change response time of the ancillarylumen having the blockage versus the ancillary lumen free of theblockage. The delay may increase as the blockage increases in severity.When a delay is detected, the RPWT system 10 a may control the pressureat the tissue site 25 according to the pressure data received from theancillary lumen free of the blockage. Further, the RPWT system 10 a mayattempt to clear the blockage by opening a corresponding solenoid valve92, 94 to atmosphere. If the RPWT system 10 a is not successful inclearing the blockage, the RPWT system 10 a may ignore any pressure datareceived from the ancillary lumen with the blockage, and operate basedon the pressure data received from the ancillary lumen free of theblockage.

Referring to FIG. 16, provided is another embodiment of the RPWT system10, referred to as the RPWT system 10 b. The instrumentation components20 of the RPWT system 10 b may include the reduced pressure source 38,the pressure sensor 39, and the instillation reservoir 41. A splitconnector 76 may be optionally employed with the RPWT system 10 b tocouple the wound dressing 12 in fluid communication with theinstillation reservoir 41. The instillation reservoir 41 may berepresentative of a container, canister, pouch, bag, or other storagecomponent suitable for holding a liquid and for providing a solution forinstillation therapy. The instillation reservoir 41 may be positioned influid communication with at least one of the ancillary ports 56, 58through the conduit housing 62. Compositions of instillation solutionmay vary according to a prescribed therapy, but examples of suitablesolutions may include hypochlorite-based solutions, silver nitrate(0.5%), sulfur-based solutions, biguanides, cationic solutions, andisotonic solutions. Like reference numerals appearing in FIG. 16 and inother figures may have analogous structure and functionality aspreviously described components, and thus, will not be furtherdescribed.

Referring to FIG. 17, the split connector 76 may be configured toseparate out at least one of the ancillary lumens 84, 86 associated withthe delivery tube 14 when the delivery tube 14 is configured as amulti-lumen tube, such as the multi-lumen tube 80 a, 80 b. A tubingsection 28 of the delivery tube 14 is shown in FIG. 17 mated to aconnector port 88 a of the split connector 76 for purposes ofillustration. In some embodiments, one of the ancillary lumens 84, 86,such as the second ancillary lumen 86, may be coupled in fluidcommunication with the instillation reservoir 41, shown in FIG. 16,through the split connector 76. For example, the split connector 76 mayinclude a first ancillary passageway 78, a second ancillary passageway81, and a primary passageway 83. As shown in FIG. 17, the firstancillary lumen 84 may be in fluid communication with the firstancillary passageway 78, the second ancillary lumen 86 may be in fluidcommunication with the second ancillary passageway 81, and the primarylumen 82 may be in fluid communication with the primary passageway 83.In some embodiments, the first ancillary passageway 78 may be adapted tobe in fluid communication with the first pair of ancillary lumens 84 a,84 b, shown in FIG. 14A, and the second ancillary passageway 81 may beadapted to be in fluid communication with the second pair of ancillarylumens 86 a, 86 b, also shown in FIG. 14A. The second ancillarypassageway 81 may be coupled in fluid communication with another tubingsection 28 of the delivery tube 14, such as the instrumentation tubing36 or the multi-lumen tubes 80 a, 80 b, at a connector port 88 b of thesplit connector 76. Further, an additional tubing section 28 of thedelivery tube 14 may be coupled at a connector port 88 c of the splitconnector 76 to provide fluid communication with the primary lumen 82and the first ancillary lumen 84 through the primary passageway 83 andthe first ancillary passageway 78, respectively. When the multi-lumentubes 80 a, 80 b are used with the split connector 76, the connectorports 88 a, 88 b, and 88 c may be configured to provide fluidcommunication with the lumens described above while blocking fluidcommunication with other lumens.

FIG. 18 is a schematic diagram illustrating additional details that maybe associated with some example embodiments of the RPWT system 10 b.FIG. 18 illustrates the reduced pressure source 38, the pressure sensor39, and the instillation reservoir 41 in separate fluid communication,for example, through separate lumens or conduits, with the adapter 22 aspreviously described. The RPWT system 10 b may additionally include thecontroller 90, and the solenoid valves 92, 94, and 96. The controller 90may be configured to receive pressure data from the pressure sensor 39and the reduced pressure source 38. The controller 90 may also beprogrammed or configured to monitor pressure at the tissue site 25,shown in FIG. 16, through the pressure data received from the pressuresensor 39. The controller 90 may further be configured to operate thereduced pressure source 38 for supplying reduced pressure to the adapter22, such as through the previously described primary lumen 82 andprimary port 60, according to the pressure data. Additionally, thecontroller 90 may further be configured to control fluid flow from theinstillation reservoir 41 to the adapter 22, such as through thepreviously described second ancillary lumen 86 and second ancillary port58.

In some embodiments, the solenoid valve 92 may be in fluid communicationwith the pressure sensor 39, the solenoid valve 94 may be in fluidcommunication with the instillation reservoir 41, and the solenoid valve96 may be in fluid communication with the reduced pressure source 38.The controller 90 may be electrically coupled or operable on thesolenoid valves 92, 94, and 96, and the reduced pressure source 38. Inthe RPWT system 10 b, the solenoid valves 92, 94, and 96 may becontrolled by the controller 90, for example, to regulate pressure atthe tissue site 25 and to clear blockages as described above. Further,the solenoid valve 94 may have various configurations for deliveringinstillation fluid from the instillation reservoir 41. As shown in FIG.18, the instillation reservoir 41 may be positioned in fluidcommunication between the solenoid valve 94 and the second ancillarylumen 86. In such an embodiment, the controller 90 may be operable toopen the solenoid valve 94 to atmosphere, thereby releasing vacuum inthe instillation reservoir 41, permitting instillation fluid in theinstillation reservoir 41 to flow into the second ancillary lumen 86toward the adapter 22. In other embodiments, the solenoid valve 94 maybe positioned in fluid communication between the instillation reservoir41 and the second ancillary lumen 86 such that opening the solenoidvalve 94 may permit instillation fluid to flow from the instillationreservoir 41 by operation of gravity. Other embodiments are possible,and other actuation devices, such as a pump, may be associated with thefluid instillation reservoir 41 to enhance the flow of instillationfluid toward the adapter 22.

Referring to FIG. 19, test results are shown as a graphical plot ofpressure measured at a tissue site by embodiments of the adapter 22including the at least one port extension 37, shown in FIGS. 10-11,compared to a plot of actual pressure present at the tissue site. InFIG. 19, a solid plot line represents the pressure measured by theadapter 22, and a dashed plot line represents the actual pressuremeasured at the tissue site as a control or baseline. Both the solid anddashed plot lines substantially overlap one another in FIG. 19,indicating that the pressure measured by the adapter 22 provides anaccurate representation of the actual pressure at the tissue site.

The use of the at least one port extension 37 may contribute to theaccuracy of the pressure measured by the adapter 22. For example,pressure sampling with the port extension 37 occurs at the distal end 45of the port extension 37, which is adapted to be in contact with or inclose proximity to a surface of the tissue site. Sampling pressurethrough the distal end 45 of the port extension 37, positioned incontact with or in close proximity to the tissue site, may minimizevariations in pressure measurements that could occur, for example, dueto pressure drops or other losses. Further, the use of the portextension 37 provides additional benefits in regard to efficient use ofinstillation fluid and improved washing of a tissue site with theinstillation fluid. For example, delivering instillation fluid throughthe distal end 45 of the port extension 37, positioned in contact withor in close proximity to the tissue site, may minimize loss ofinstillation fluid to other parts of the system, such as, for example,the dressing and the distribution manifold. Thus, the port extension 37may permit instillation fluid to be delivered directly to a surface ofthe tissue site without requiring, for example, saturation of thedistribution manifold or filling of the wound dressing before theinstillation fluid is able to reach a surface of the tissue site.

Referring to FIG. 20, test results are shown as a graphical plot ofpressure measured at an outward-facing side of a distribution manifoldby an embodiment of the adapter 22 including a single port extension 37,shown in FIG. 11, compared to a plot of pressure measured at atissue-facing side of the distribution manifold. In FIG. 20, a solidplot line represents pressure measured at an outward-facing side of thedistribution manifold, such as through the second ancillary port 58 ofthe adapter 22, shown in FIG. 11, which may be adapted to terminate orreside at or on the outward-facing side of the distribution manifold. Adashed plot line in FIG. 20 represents the pressure measured through theadapter 22 and the distal end 45 of the port extension 37, which may bepositioned at the tissue-facing side of the distribution manifold and incontact with or in close proximity to the tissue site, providing anaccurate representation of the actual pressure at the tissue site asdescribed above. FIG. 20 illustrates a mean pressure difference of about7 mm Hg between the solid plot line and the dashed plot line, indicatinga pressure drop or loss exists across a thickness of the distributionmanifold between the outward-facing side and the tissue-facing side. Asfluid and particulate exposure from the tissue site to the distributionmanifold occurs over time, increases in pressure drop and losses canoccur, reducing a life expectancy of the distribution manifold. Thus,the life expectancy of the distribution manifold may be determined bycomparing the pressure measured at the outward-facing side of thedistribution manifold to the pressure measured at the tissue-facing sideof the distribution manifold.

Referring generally to the figures, this disclosure provides methodsthat may be suitable for use with instillation therapy andreduced-pressure therapy. In some illustrative embodiments, a method forevaluating a service life of a distribution manifold for treating atissue site may include positioning the distribution manifold 24 on asurface of the tissue site 25. Further, the method may includepositioning the adapter 22 including the port extension 37, as shown inFIG. 11, for example, on the distribution manifold 24. In such anembodiment, the distal end 45 of the port extension 37 may extendoutward from the entry surface 55 toward the tissue-facing side 61 ofthe distribution manifold 24, and the second ancillary port 58 mayterminate on the entry surface 55 at the outward-facing side 63 of thedistribution manifold 24.

Further, the method may include inserting the distal end 45 of the portextension 37 into the distribution manifold 24, and applying reducedpressure to the distribution manifold 24 through the primary port 60 ofthe adapter 22. Further, the method may include measuring a firstpressure between the surface of the tissue site 25 and the tissue-facingside 61 of the distribution manifold 24 through the first ancillary port56 and the distal end 45 of the port extension 37. Further, the methodmay include measuring a second pressure at the outward-facing side 63 ofthe distribution manifold 24 through the second ancillary port 58.Further, the method may include calculating a difference between thefirst pressure and the second pressure to provide a differentialpressure.

In some embodiments, the method may include changing or replacing thedistribution manifold 24 if the differential pressure is greater thanabout 15 mm Hg. Further, in some embodiments, applying reduced pressuremay include applying reduced pressure to the outward-facing side 63 ofthe distribution manifold 24. Further, in some embodiments, the bore 47of the port extension may define an isolated communication passagewaybetween the distal end 45 of the port extension 37 and the firstancillary port 56. Further, in some embodiments, applying reducedpressure to the distribution manifold 24 may move the outward-facingside 63 of the distribution manifold 24 closer to the surface of thetissue site 25 such that the distal end 45 of the port extension 37contacts the surface of the tissue site 25. Further, in someembodiments, the method may include covering the outward-facing side 63of the distribution manifold 24 with the drape 26 to provide a sealedspace between the drape 26 and the tissue site 25. The distributionmanifold 24 may be positioned in the sealed space.

In other embodiments, a method for evaluating a service life of adistribution manifold for treating a tissue site may include positioningthe distribution manifold 24 on a surface of the tissue site 25.Further, the method may include applying reduced pressure to theoutward-facing side 63 of the distribution manifold 24. Further, themethod may include measuring a first pressure between the surface of thetissue site 25 and the tissue-facing side 61 of the distributionmanifold 24. Further, the method may include measuring a second pressureat the outward-facing side 63 of the distribution manifold 24. Further,the method may include calculating a difference between the firstpressure and the second pressure to provide a differential pressure.

In some illustrative embodiments, a method for measuring and controllingpressure at a tissue site may include positioning the distributionmanifold 24 adjacent a surface of the tissue site 25. The distributionmanifold 24 may include a tissue-facing side 61 facing the tissue site25, and an outward-facing side 63 opposite the tissue-facing side 61.Further, the method may include positioning the adapter 22 adjacent thedistribution manifold 24. In such an embodiment, the adapter 22 mayinclude the first ancillary port 56, the second ancillary port 58, thefirst port extension 37 a, and the second port extension 37 b as shownin FIG. 10.

Further, the method may include inserting the distal end 45 of the firstport extension 37 a and the distal end 45 of the second port extension37 b into the distribution manifold 24. Further, the method may includeapplying reduced pressure from the reduced pressure source 38 to thedistribution manifold 24 through the primary port 60. Further, themethod may include measuring a first pressure between the tissue-facingside 61 of the distribution manifold 24 and the surface of the tissuesite 25 through the first port extension 37 a. Further, the method mayinclude measuring a second pressure between the tissue-facing side 61 ofthe distribution manifold 24 and the surface of the tissue site 25through the second port extension 37 b. Further, the method may includecontrolling the reduced pressure from the reduced pressure source 38according to the first pressure and the second pressure.

In other embodiments, a method for measuring and controlling pressure ata tissue site may include positioning the distribution manifold 24adjacent a surface of the tissue site 25. The distribution manifold 24may include the tissue-facing side 61 facing the tissue site 25, and anoutward-facing side 63 opposite the tissue-facing side 61. Further, themethod may include applying reduced pressure from the reduced pressuresource 38 to the distribution manifold 24. In some embodiments, applyingreduced pressure may include applying reduced pressure to theoutward-facing side 63 of the distribution manifold 24. Further, themethod may include measuring a first pressure between the surface of thetissue site 25 and the tissue-facing side 61 of the distributionmanifold 24. Further, the method may include measuring a second pressurebetween the surface of the tissue site 25 and the tissue-facing side 61of the distribution manifold 24. Further, the method may includecontrolling the reduced pressure from the reduced pressure source 38according to the first pressure and the second pressure. Further, insome embodiments, the method may include determining a first time periodfor the first pressure to respond to a change in the reduced pressure atthe reduced pressure source 38; determining a second time period for thesecond pressure to respond to the change in reduced pressure at thereduced pressure source 38; controlling the reduced pressure accordingto the first time period if the first time period is less than thesecond time period; and controlling the reduced pressure according tothe second time period if the second time period is less than the firsttime period.

In some illustrative embodiments, a method for instilling fluid at atissue site may include positioning the distribution manifold 24adjacent a surface of the tissue site 25. The distribution manifold 24may include the tissue-facing side 61 facing the tissue site 25, and theoutward-facing side 63 opposite the tissue-facing side 61. Further, themethod may include positioning the adapter 22 adjacent the distributionmanifold 24. In such an embodiment, the adapter 22 may include at leastone of the ancillary ports 56, 58, and at least one port extension 37 asshown in FIGS. 10-11. Further, the method may include inserting thedistal end 45 of the port extension 37 into the distribution manifold24, and delivering fluid to the surface of the tissue site 25 throughthe distal end 45 of the port extension 37.

In some embodiments, the method for instilling fluid may includedelivering reduced pressure to the outward-facing side 63 of thedistribution manifold 24 through, for example, the primary port 60 ofthe adapter 22. Further, in some embodiments, the method for instillingfluid may include measuring a pressure between the surface of the tissuesite 25 and the tissue-facing side 61 of the distribution manifold 24,and controlling the delivery of reduced pressure according to thepressure.

In other embodiments, a method for instilling fluid at a tissue site mayinclude positioning the distribution manifold 24 adjacent a surface ofthe tissue site 25. The distribution manifold 24 may include atissue-facing side 61 facing the tissue site 25, and an outward-facingside 63 opposite the tissue-facing side 61. Further, the method mayinclude delivering fluid directly between the surface of the tissue site25 and the tissue-facing side 61 of the distribution manifold 24.

While shown in a few illustrative embodiments, a person having ordinaryskill in the art will recognize that the systems, apparatuses, andmethods described herein are susceptible to various changes andmodifications. Moreover, descriptions of various alternatives usingterms such as “or” do not require mutual exclusivity unless clearlyrequired by the context, and the indefinite articles “a” or “an” do notlimit the subject to a single instance unless clearly required by thecontext. Components may be also be combined or eliminated in variousconfigurations, for example, for purposes of sale, manufacture,assembly, or use. Further, components disclosed in connection with oneembodiment may be used in connection with another embodiment.

The appended claims set forth novel and inventive aspects of the subjectmatter described above, but the claims may also encompass additionalsubject matter not specifically recited in detail. For example, certainfeatures, elements, or aspects may be omitted from the claims if notnecessary to distinguish the novel and inventive features from what isalready known to a person having ordinary skill in the art. Features,elements, and aspects described herein may also be combined or replacedby alternative features serving the same, equivalent, or similar purposewithout departing from the scope of this disclosure as defined by theappended claims.

1. An adapter for providing fluid communication with a distributionmanifold at a tissue site, the adapter comprising: a base defining amounting plane, the mounting plane having a first planar side and asecond planar side opposite the first planar side, the base including amounting surface coplanar with the first planar side and facing thefirst planar side; a conduit housing supported by the base and includinga recessed region defining an entry surface, the conduit housing and therecessed region positioned on the first planar side with the entrysurface facing the first planar side; a primary port on the entrysurface; at least one ancillary port on the entry surface; and at leastone port extension including a proximal end, a distal end, and a borebetween the proximal end and the distal end, the distal end of the portextension positioned on the second planar side in fluid communicationwith the ancillary port through the bore.
 2. The adapter of claim 1,wherein the base is attached to the conduit housing and positioned aboutthe recessed region.
 3. The adapter of claim 1, wherein the basesurrounds the recessed region.
 4. The adapter of claim 1, wherein theentry surface is spaced apart from the first planar side of the mountingplane.
 5. The adapter of claim 1, wherein the primary port is positionedat an apex of the recessed region.
 6. The adapter of claim 5, whereinthe apex of the recessed region is spaced apart from the first planarside of the mounting plane.
 7. The adapter of claim 1, wherein theprimary port is spaced apart from the ancillary port such that theancillary port is positioned closer to the first planar side of themounting plane than the primary port.
 8. The adapter of claim 1, whereinthe port extension extends beyond the mounting surface through themounting plane to the second planar side, the mounting surface and thesecond planar side configured to face the distribution manifold.
 9. Theadapter of claim 1, wherein the distal end of the port extension isspaced apart from the mounting plane on the second planar side.
 10. Theadapter of claim 1, wherein the proximal end of the port extension ispositioned on the first planar side of the mounting plane in fluidcommunication with the ancillary port, the distal end of the portextension extending through the mounting plane to the second planarside.
 11. The adapter of claim 1, wherein the port extension iscollapsible in a lengthwise direction.
 12. The adapter of claim 1,wherein the proximal end of the port extension is coupled to the entrysurface about the ancillary port.
 13. The adapter of claim 1, whereinthe bore of the port extension defines an isolated communicationpassageway between the ancillary port and the distal end of the portextension.
 14. The adapter of claim 1, wherein the distal end of theport extension carries a plurality of castellations, the castellationscomprising projections extending outward from the distal end.
 15. Theadapter of claim 14, wherein the castellations are disposed about aperimeter of the distal end of the port extension.
 16. The adapter ofclaim 14, wherein the castellations are collapsible.
 17. The adapter ofclaim 14, wherein the castellations are spaced apart from one anotherabout the distal end of the port extension.
 18. The adapter of claim 14,further comprising an opening defined between each of the castellationsand in fluid communication with the bore.
 19. The adapter of claim 1,wherein the at least one ancillary port comprises a first ancillary portand a second ancillary port, the port extension coupled to the entrysurface about the first ancillary port and extending outward from theentry surface and beyond the mounting surface of the base, the secondancillary port terminating at the entry surface.
 20. The adapter ofclaim 1, wherein the at least one ancillary port comprises a firstancillary port and a second ancillary port, and wherein the at least oneport extension comprises a first port extension and a second portextension, the first port extension coupled about the first ancillaryport, and the second port extension coupled about the second ancillaryport.
 21. The adapter of claim 1, further comprising channels positionedon the entry surface to direct liquid away from the ancillary port andinto the primary port.
 22. The adapter of claim 21, wherein the channelscomprise: a linear channel section along approximately half of the entrysurface; and a radial channel section along approximately one-third ofthe entry surface.
 23. The adapter of claim 1, further comprising radialchannels positioned on the base to direct liquid from a periphery of thebase away from the ancillary port.
 24. The adapter of claim 23, furthercomprising an intermediate collection channel positioned on the base todirect liquid into the radial channels. 25.-52. (canceled)
 53. A methodfor treating a tissue site, comprising: providing a distributionmanifold comprising a tissue-facing side for facing the tissue site andan outward-facing side opposite the tissue-facing side; applying reducedpressure to the outward-facing side of the distribution manifold;measuring a first pressure at the tissue-facing side of the distributionmanifold; measuring a second pressure at the outward-facing side of thedistribution manifold; and calculating a difference between the firstpressure and the second pressure to provide a differential pressure. 54.The method of claim 53, further comprising changing the distributionmanifold if the differential pressure is greater than 15 mm Hg.
 55. Themethod of claim 53, further comprising covering the outward-facing sideof the distribution manifold with a drape to provide a sealed spacebetween the drape and the tissue site, the distribution manifoldpositioned in the sealed space.
 56. A method for measuring andcontrolling pressure at a tissue site, comprising: positioning adistribution manifold adjacent a surface of the tissue site, thedistribution manifold comprising a tissue-facing side facing the tissuesite and an outward-facing side opposite the tissue-facing side;positioning an adapter adjacent the distribution manifold, the adaptercomprising: a conduit housing including a recessed region defining anentry surface, the entry surface facing the outward-facing side of thedistribution manifold, a primary port on the entry surface, a firstancillary port and a second ancillary port on the entry surface, and afirst port extension and a second port extension, the first portextension and the second port extension each including a proximal end, adistal end, and a bore between the proximal end and the distal end, thedistal end of the first port extension in fluid communication with thefirst ancillary port, the distal end of the second port extension influid communication with the second ancillary port; inserting the distalend of the first port extension and the distal end of the second portextension into the distribution manifold; applying reduced pressure froma reduced pressure source to the distribution manifold through theprimary port; measuring a first pressure between the tissue-facing sideof the distribution manifold and the surface of the tissue site throughthe first port extension; measuring a second pressure between thetissue-facing side of the distribution manifold and the surface of thetissue site through the second port extension; and controlling thereduced pressure from the reduced pressure source according to the firstpressure and the second pressure.
 57. A method for measuring andcontrolling pressure at a tissue site, comprising: positioning adistribution manifold adjacent a surface of the tissue site, thedistribution manifold comprising a tissue-facing side facing the tissuesite and an outward-facing side opposite the tissue-facing side;applying reduced pressure from a reduced pressure source to thedistribution manifold; measuring a first pressure between the surface ofthe tissue site and the tissue-facing side of the distribution manifold;measuring a second pressure between the surface of the tissue site andthe tissue-facing side of the distribution manifold; and controlling thereduced pressure from the reduced pressure source according to the firstpressure and the second pressure.
 58. The method of claim 57, whereinapplying reduced pressure comprises applying reduced pressure to theoutward-facing side of the distribution manifold.
 59. The method ofclaim 57, further comprising: determining a first time period for thefirst pressure to respond to a change in the reduced pressure at thereduced pressure source; determining a second time period for the secondpressure to respond to the change in reduced pressure at the reducedpressure source; controlling the reduced pressure according to the firsttime period if the first time period is less than the second timeperiod; and controlling the reduced pressure according to the secondtime period if the second time period is less than the first timeperiod. 60.-62. (canceled)
 63. A method for instilling fluid at a tissuesite, comprising: positioning a distribution manifold adjacent a surfaceof the tissue site, the distribution manifold comprising a tissue-facingside facing the tissue site and an outward-facing side opposite thetissue-facing side; and delivering fluid directly between the surface ofthe tissue site and the tissue-facing side of the distribution manifold.64. The method of claim 63, further comprising delivering reducedpressure to the outward-facing side of the distribution manifold. 65.The method of claim 64, further comprising measuring a pressure betweenthe surface of the tissue site and the tissue-facing side of thedistribution manifold, and controlling the delivery of reduced pressureaccording to the pressure.
 66. An adapter for providing fluidcommunication with a distribution manifold at a tissue site, the adaptercomprising: a base including a mounting surface; a housing supported bythe base and including an opening extending inbound of the mountingsurface; a primary port in the opening; at least one ancillary port inthe opening; and at least one ancillary fluid pathway extending from theat least one ancillary port outbound of the mounting surface.
 67. Theadapter of claim 66, wherein the at least one ancillary fluid pathwayextends beyond the mounting surface.
 68. The adapter of claim 66,wherein the primary port and the at least one ancillary port arepositioned inbound of the mounting surface and on an interior surface ofthe opening.
 69. The adapter of claim 66, wherein the primary port isspaced apart from the at least one ancillary port such that the at leastone ancillary port is positioned closer to the mounting surface than theprimary port.
 70. The adapter of claim 66, wherein the at least oneancillary fluid pathway has a proximal end and a distal end, theproximal end positioned inbound of the mounting surface and the distalend positioned outbound of the mounting surface.
 71. The adapter ofclaim 66, wherein the opening has an apex inbound of the mountingsurface, and wherein the primary port is positioned at the apex.
 72. Theadapter of claim 66, wherein the at least one ancillary fluid pathwaycomprises an auxiliary tube including a proximal end, a distal end, anda bore between the proximal end and the distal end, the distal end ofthe auxiliary tube positioned outbound of the mounting surface and influid communication with the ancillary port through the bore.
 73. Amethod for treating a tissue site, comprising: positioning adistribution manifold on a surface of the tissue site, the distributionmanifold comprising a tissue-facing side facing the tissue site and anoutward-facing side opposite the tissue-facing side; providing anadapter, comprising: a conduit housing including a recessed regiondefining an entry surface, a primary port on the entry surface, anancillary port on the entry surface, and an ancillary fluid pathwaythrough the conduit housing and extending outward from the conduithousing; positioning the adapter on the distribution manifold such thatthe ancillary port is positioned on the outward-facing side of thedistribution manifold and the ancillary fluid pathway extends into thedistribution manifold.
 74. The method of claim 73, wherein the entrysurface faces the outward-facing side of the distribution manifold whenthe adapter is positioned on the distribution manifold.
 75. The methodof claim 73, further comprising: applying reduced pressure to thedistribution manifold through the primary port; measuring a firstpressure through the ancillary fluid pathway; measuring a secondpressure through the ancillary port; and calculating a differencebetween the first pressure and the second pressure to provide adifferential pressure.
 76. The method of claim 75, wherein the firstpressure is measured between the surface of the tissue site and thetissue-facing side of the distribution manifold.
 77. The method of claim75, wherein the second pressure is measured at the outward-facing sideof the distribution manifold.
 78. The method of claim 75, furthercomprising changing the distribution manifold if the differentialpressure is greater than 15 mm Hg.
 79. (canceled)